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Researchers claim to have developed a potential new gene therapy technique for arthritis, paving way for a jab that could protect joints from wear and tear.

Scientists led by Brendan Lee, professor of molecular and human genetics at Baylor College of Medicine unravel the effects of a naturally occurring protein called lubricin or Proteoglycans 4 that protects against aging as well as helping with post-injury related changes.

"This protein also affects the metabolism of the cartilage and does it in a way that prevents its breakdown," said Lee. Merry ZC Ruan, in Lee's laboratory, developed a special imaging technique called phase contrast ultra-high resolution micro-computed tomography that allowed them to "see" the tiny cartilage in the knee joint and quantify that amount in the mouse joint.

To identify new targets for treating osteoarthritis, they focused on a genetic disease in which the disorder starts early in children. These individuals are deficient in lubricin. They then studied mice that produced higher levels lubricin and found that its increased amounts was not harmful.

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Late to bed and early to rise could well be the New Age recipe for heart disease. It is no longer only what you eat and drink that determines your health. Sleep deprivation is also emerging as a key reason for heart and other lifestyle ailments.

According to studies, almost 15% of adults in Asian countries suffer from sleep-related problems, which can give rise to several psychological and physiological changes, besides increasing the risk of developing hypertension, type II diabetes and increased body weight.

An international study published in the American Journal of Respiratory and Critical Care Medicine proved that obstructive sleep apnea represents a stress that promotes insulin resistance and hence narrows blood vessels. In another study published in a journal of the American Heart Association, researchers from the University of Sao Paulo Medical School, found that sleep apnea is an independent risk factor for the development of atherosclerosis or hardening of arteries. Thus, those suffering from sleep apnea have an increased risk for stroke, heart attack and peripheral vascular disease.

However, more Indians, especially men, suffer from sleep related disorders than their western counterparts. "Though obesity is a major risk factor when it comes to sleep apnea, it is still higher amongst men in the US," said Dr Zarir Udwadia, chest physician at PD Hinduja Hospital, who had conducted a study in 2000 and found that 9-10% Indian urban men suffer from sleep related disorders. "The facial structure of Indians is such that the nose is generally a little flatter and may cause problems in breathing. Though these are our findings, but research is still being done on the subject to confirm the same," said Dr Udwadia.

Psychiatrists say that lack of sleep can also lead to a series of psychosomatic problems. Psychiatrist Dr Harish Shetty said, "Lack of sleep can lead to irritability, anger and sadness." But chronic lack of sleep can lead to much worse problems. "The constant lack of sleep over a period of time leads to lack of co-ordination between brain and the rest of the body. Since the neuro-endocrinological system goes haywire, there is an increase in the steroid levels in the brain. This can also lead to hormonal imbalance and depression," he said.

The right sleeping conditions

* Keep your room cool, dark and quiet.

* room temperature should be between 20°C and 25°C and with a humidity level between 60% and 70%.

* It is important to choose sleeping clothes that keep your body warm but do not overheat it.

* You will fall asleep more easily if you follow a regular bedtime routine. This routine should include quiet, non-stimulating activities.

* Various habits like taking a warm bath, reading, turning down the lights, playing music quietly, that assist sleep.

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Anaemia doesn't just affect the lower socio-economic strata, many women from higher income groups are also afflicted, say doctors. The reasons however, differ drastically. "While women from lower economic groups do not have adequate nourishment, those from affluent backgrounds have low haemoglobin levels as they are either dieting or eating more of junk food
. "Junk food is not a great source of iron. Women who diet to lose weight lose out on iron as well,", adding severe anaemia afflicts more women in the lower economic strata.

Anaemia is a condition in which the number of red blood cells or their oxygen-carrying capacity is insufficient to meet physiologic needs, which vary according to age, sex, altitude, smoking and pregnancy status. A person is considered anaemic if the haemoglobin falls below 13.5gm/100 in men and below 12gm/100 ml in women. For Indian women, even 11gm/100 ml is considered normal

Cause: Iron deficiency is thought to be the most common cause of anaemia globally, although other conditions, such as folate, vitamin B12 and vitamin A deficiencies, chronic inflammation, parasitic infections, and inherited disorders can all cause anaemia

Symptoms:
In its severe form, it is associated with fatigue, weakness, dizziness and drowsiness. Pregnant women and children are particularly vulnerable

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A 'functional cure' for AIDS found
Treating people with HIV rapidly after they have become infected with the virus that causes AIDS may be enough to achieve a "functional cure" in a small proportion of patients diagnosed early, according to new research.

Scientists in France who followed 14 patients who were treated very swiftly with HIV drugs but then stopped treatment found that even when they had been off therapy for more than seven years, they still showed no signs of the virus rebounding. The research, published in the journal PLoS Pathogens, follows news earlier this month about a baby girl in Mississippi in the US being effectively cured of the HIV after receiving very early treatment.

Christine Rouzioux, a professor at Necker Hospital and University Paris Descartes and a member of the initial team who identified HIV 30 years ago, said the new results showed the number of infected cells circulating in the blood of these patients, known as "post-treatment controllers", kept falling even without treatment for many years.

"Early treatment in these patients may have limited the establishment of viral reservoirs, the extent of viral mutations, and preserved immune responses. A combination of those may contribute to control infection in post-treatment controllers," she said.

"The shrinking of viral reservoirs ... closely matches the definition of 'functional' cure," she said. A functional cure describes when the virus is reduced to such low levels that it is kept at bay even without continuing treatment. The virus, however, is still detectable in the body.

Most of the some 34 million people with HIV across the world will have to take anti-AIDS drugs known as antiretroviral therapy for the whole of their lives. These drugs generally keep the disease in check but also have side effects and a high cost impact on health systems.

Worldwide, the number of people newly infected with HIV, which can be transmitted via blood and by semen during sex, is falling.

At 2.5 million, the number of new infections in 2011 was 20% lower than in 2001, according to the United National AIDS programme ( UNAIDS). And deaths from AIDS fell to 1.7 million in 2011, down from a peak of 2.3 million in 2005.

They began by gathering a group of healthy adult male rats of a type that generally enjoys running . Then they gave some of the animals access to unlocked running wheels and let them exercise whenever and for as long as they liked.

The exercise was fully under the animals' control.

Having determined how the animals spontaneously liked to run, the researchers next placed other rats in mechanised, lockable wheels that were controlled exclusively by the scientists.

The scientists then forced these rats to run. To the extent possible, the researchers mimicked the animals' normal, spontaneous exercise pattern, having the rats run during the portion of the day when they naturally would be active and creating frequent stops and starts in their running, just as the rats that ran freely had done.

The animals' daily mileage was equivalent to that of the voluntary runners. Meanwhile, a third group of rats ran on little mechanised treadmills, at a steady, even pace, without fits and starts of voluntary running. The animals could not control their speed or distance. A final group remained sedentary. All of the animals exercised, or lounged, for six weeks. The next day, the animals were placed in a large, unfamiliar maze-like cage designed to determine their levels of anxiety or confidence. If they froze or scurried to the darkest corners of the cage and refused to explore, they were considered to be highly anxious and unsettled.

The treadmill runners and the sedentary animals were, the results showed, extremely anxious. They froze or ran for the darkness at the first opportunity . But the animals that had exercised on the running wheels, whether they could control their exercise regimens or not, proved to be quite resilient. They bounced back emotionally from the imposed stresses and were willing to explore the lighted regions of their new surroundings on the next day.

What this suggests, says Benjamin Greenwood, a professor of integrative physiology at the University of Colorado who designed and led the study, is that "even forced exercise increases stress resistance ." If, in other words, you are being cajoled to exercise, whether by your conscience, your partner or some other overriding force, you nevertheless are likely to wind up feeling less anxious, more relaxed and happier afterward, even if you're not having fun during the workout.

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Visceral fat, or fat stored deep in the abdominal cavity, can put a person at an increased risk for colon cancer, according to a new study.

"There has been some skepticism as to whether obesityper se is a bona fide cancer risk factor, rather than the habits that fuel it, including a poor diet and a sedentary lifestyle," said Derek M. Huffman, Ph.D., postdoctoral fellow at the Institute for Aging Research at the Albert Einstein College of Medicine in Bronx, N.Y.

"Although those other lifestyle choices play a role, this study unequivocally demonstrates that visceral adiposity is causally linked to intestinal cancer."

Prior research has shown that obesity markedly increases the likelihood of being diagnosed with and dying from many cancers. Huffman and colleagues sought to determine if removing visceral fat in mice genetically prone to developing colon cancer might prevent or lessen the development of these tumors.

They randomly assigned the mice to one of three groups. Mice in the first group underwent a sham surgery and were allowed to eat an unrestricted "buffet style" diet, for the entirety of the study, which resulted in these mice becoming obese. Those in the second group were also provided an unrestricted diet and became obese, but they had their visceral fat surgically removed at the outset of the study. Mice in the third group also underwent a sham surgery, but were provided only 60 per cent of the calories consumed by the other mice in order to reduce their visceral fat by dieting.

"Our sham-operated obese mice had the most visceral fat, developed the greatest number of intestinal tumors, and had the worst overall survival," Huffman said.

"However, mice that had less visceral fat, either by surgical removal or a calorie-restricted diet, had a reduction in the number of intestinal tumors. This was particularly remarkable in the case of our group where visceral fat was surgically removed, because these mice were still obese, they just had very little abdominal fat."

The researchers then subdivided the groups by gender. In female mice, the removal of visceral fat was significantly related to a reduction in intestinal tumors, but calorie restriction was not. In male mice, calorie restriction had a significant effect on intestinal tumors, but removal of visceral fat did not.

"This suggests that there are important gender differences in how adiposity and nutrients interact with the tumor environment," Huffman said. "In addition, the study emphasizes the need to promote strategies that reduce visceral fat in abdominally obese individuals."

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A human liver can now be kept "warm, alive and functioning" outside the human body for it to be transplanted into a new patient.

In a world's first, scientists from Oxford University and doctors from King's College Hospital have successfully "kept alive" a donated human liver outside a human being and then successfully transplanted it into a patient in need of a new liver.

Currently, transplantation depends on preserving donor organs by putting them 'on ice' — cooling them to slow their metabolism. But this often leads to organs becoming damaged.

So far the procedure, which will be a major boon for countries like India that already face an acute shortage of donor livers for transplantation, has been performed on two patients; both are making excellent recoveries.

The innovation is a machine developed over 15 years at Oxford University that can preserve a functioning liver outside the body for 24 hours.

A donated human liver connected to the device is raised to body temperature and oxygenated red blood cells are circulated through its capillaries. Once on the machine, a liver functions normally just as it would inside a human body, regaining its colour and producing bile.

Based on pre-clinical data, the team says the new device will lead to better preservation of livers that would otherwise be discarded as unfit for transplantation — potentially as much as doubling the number of organs available for transplant and prolonging the maximum period of organ preservation to 24 hours.

"If we can introduce technology like this into everyday practice, it could be a real, bona fide game changer for transplantation as we know it," says professor Nigel Heaton, director of transplant surgery at King's College Hospital. "Buying the surgeon extra time extends the options open to our patients, many of whom would otherwise die waiting for an organ to become available."

Dr Wayel Jassem, liver transplant surgeon at King's College Hospital, who performed both transplant operations, says: "There is always huge pressure to get a donated liver to the right person within a very short space of time. For the first time, we now have a device that is designed specifically to give us extra time to test the liver, to help maximise the chances of the recipient having a successful outcome. This technology has the potential to be hugely significant, and could make more livers available for transplant, and in turn save lives."

In Europe and the US, about 13,000 liver transplants are undertaken each year. But there is a combined waiting list of about 30,000 patients, and up to 25% of these die while awaiting transplantation.

Meanwhile, over 2,000 livers are discarded annually because they are either damaged by oxygen deprivation or do not survive cold preservation due to elevated intracellular fat.

In a warning that is bound to cause a fresh row over the quality of Asian herbal medicines, British scientists were due to announce on Tuesday that millions of people in Asia — specially in India and China — might be exposed to the risk of kidney failure and bladder cancer from taking herbal medicines widely available in the continent.

Scientists from King's College London have found that many herbal medicines used for a wide range of conditions — including slimming, asthma and arthritis — are derived from a botanical compound containing aristolochic acids. These products are now banned in the US and many European countries, but herbs containing these toxic acids can still be bought in China and other countries in Asia, and are also available worldwide over the internet.

The scientists reviewed worldwide cases of aristolochic acid nephropathy (AAN), a type of kidney failure caused by the intake of these acids. They suggest there may be many thousands of cases across Asia that are undiagnosed or misdiagnosed. With the outcome of their study, the researchers hope to raise awareness of the risks of aristolochic acids and reduce the global disease burden from this severe condition.

"We do know that preparations containing aristolochic acid (AA) are widely used in India and that this is associated with chronic kidney disease and kidney cancer if a sufficient dose is taken," lead author Professor Graham Lord told TOI. "Ethnopharmacological analyses suggest that aristolochia is widely used in India. India must start better monitoring of medicines containing herbal remedies and also assessment of patients with chronic kidney disease and kidney cancer for the presence of AA."

Lord said at the moment they did not how widespread the problem was in India. "We have found evidence that many millions of people continue to be exposed to significant health risk due to these herbal medicines, widely used in China and India," he said. "There is also a striking lack of good quality evidence that might help guide the diagnosis and management of AAN."

Their paper, published in "Annals of Internal Medicine", indicates that the regulatory measures that have been adopted by national and international agencies so far may be inadequate in preventing harmful exposure to aristolochic acids.

The compound is linked to many cases of kidney diseases and urothelial cancer, a form of cancer of which bladder cancer is the most known variant.

The authors reviewed the latest data on the epidemiology of AAN. They used several search engines to include all publications that are about or refer to aristolochic acids and Chinese herbal nephropathy, and identified 42 different case studies and one trial relating to the management of the disease.

While explaining the origin and development of the disease, they propose a protocol that should make it easier to diagnose AAN. In addition, they suggest a new disease classification to help international clinicians better identify AAN patients and draft guidelines for the treatment of these patients.

The research team consisted of an international collaboration of scientists from Belgium, Czech Republic, Germany and the UK. "This research is a great demonstration of how international scientific collaboration is vital in helping to describe how a toxin used in widely available products can lead to cancer," said Dr Refik Gokmen, co-author from King's College London.

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Swine flu virus may be now resistant to key medicine Tamiflu, raising fears a new outbreak may be difficult to fight, Australian research has warned. While just 2% of swine flu (H1N1) strains around the world are resistant to Tamiflu, the researchers found mutations in all strains of the swine flu that suggest they might be prone to develop resistance. They found that one in five cases of swine flu in an area of Australia in 2011 were resistant to the medicine.

Dr Aeron Hurt from the WHO centre in Melbourne, said the bug appears more prone than other types of flu to developing drug resistance, The Australian said. Tamiflu resistance develops when a patient under treatment receives the drug to control their symptoms. In most flu viruses, the changes that make the virus resistant also make it less likely to spread to others. With swine flu, this has not happened and the virus remains fit enough to spread to others, Hurt said